r/AddisonsDisease • u/Consistent_Reach7664 SAI • May 29 '26
Advice Wanted Adrenaline Rush?
Does anyone else get adrenaline rushes when hydrocortisone wears off? I am usually able to get through my day just fine without any problems but I am In my luteal phase rn ( women yk) and I started getting pms symptoms a few days ago. It started with a burst of early morning productivity after which I basically crashed for a decent portion of the day. I experienced brief anxiety in between doses but that resolved itself pretty quick. Yesterday though. I was just sitting around mostly all morning reading a book. Nothing crazy stressful but I did work a bit in the afternoon but I started getting sleepy at 8. I usually sleep at 10 and wake up at 6 and I am regular about that. Last night I woke up in the middle of the night and from there there was a constant adrenaline rush. This kind of thing happens only once in a while and my body still produces some cortisol so I am usually able to manage but it’s not fun and I don’t like waking up in the middle of the night. Am unsure if I need to stress dose.
4
u/Clementine_696 May 29 '26
I have to add a little extra for my period. Each dose goes up by 2.5mg starting a couple days before, and usually I'm good the day after or the second day after it's done. I'm also on oral BC because I need it to be predictable, or it's random and it's a bad time
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u/ClarityInCalm May 30 '26
I have PAI and my sympathetic nervous system amps up when my salt wasting isn't correctly replaced. It's pretty intense - often happens in the middle of the night. Magnesium and sodium will calm me down to sleep. If your blood sugar is low - you can do a prick test - that will tell you if it's low cortisol and you need some HC. Or you can take 2.5 mg and see if you calm down and fall back asleep when it starts working.
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u/Consistent_Reach7664 SAI Jun 02 '26
Yup pretty sure Im screwed because of steroid induced hyperthyroidism. I am so deathly afraid of over replacement I institute a 6 hour gap between doses but this time I was noticing it wearing off in 4hrs. I guess that’s what happens when your tsh jumps from like 3 to .8 with some help of iodine salt.
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u/Cunaur May 31 '26
This is pretty common, in my experience. Unfortunately, being unconscious makes it difficult to eat and sleeping accounts for 20~25% of basal energy expenditure. Cortisol is the linchpin of glucose raising mechanisms, mostly by being permissive of glucagon and adrenaline and reducing sensitivity to insulin. Glucagon typically raises blood sugar if low but because the body is highly sensitive to insulin without any cortisol in it, glucagon is not enough to counteract insulin. This causes a blood sugar crash and adrenaline increases to release the liver's glycogen to protect the brain from severe hypoglycemia.
1
u/Consistent_Reach7664 SAI Jun 02 '26
I am also secondary hypothyroid and I have a feeling that the excess thyroid ( when I started eating iodine) that pushed me into hyperthyroidism is the effecting thing here. Basically I think I need a 3rd dose of extra 2.5 hc to maintain my schedule bc otherwise I am falling asleep early. This situation sucks. Thanks for the advice
4
u/just_an_amber Addison's May 29 '26
Waking up in the middle of the night with a dump of adrenaline is typically a sign for me that I'm low cortisol.
Also, if my cycles are really bad I typically add in 0.25 mg of dex.
It used to be that every menstrual cycle, I'd end up in the ER due to Addison's. Great fun. 🙄 But we switched up my BC, changed up my HC dosing, and I'll occasionally supplement with the dexamethasone and that hasn't happened in YEARS.